Provider Demographics
NPI:1255379442
Name:NGUYEN, TRI MINH (MD)
Entity type:Individual
Prefix:DR
First Name:TRI
Middle Name:MINH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20414 N 27TH AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-3250
Mailing Address - Country:US
Mailing Address - Phone:623-879-6000
Mailing Address - Fax:623-516-2000
Practice Address - Street 1:20414 N 27TH AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-3250
Practice Address - Country:US
Practice Address - Phone:623-879-6000
Practice Address - Fax:623-516-2000
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30646174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ935752Medicaid
AZI29265Medicare UPIN